[Remote] Clinical Pharmacist Reviwer- REMOTE

Note: The job is a remote job and is open to candidates in USA. reputed company is a unique pharmacy benefit manager focused on connecting care for those they serve. They are seeking a Clinical Pharmacist Reviewer responsible for processing and documenting Utilization Management requests and collaborating with reputed company providers on clinical product coverage issues.

Responsibilities

• Process the clinical evaluation for coverage determination requests for prior authorization (PA) or other utilization management (UM) programs, including quantity limits, reputed company therapy, formulary exception and tier exception; this includes consideration of the denial language and appropriateness of the decision as it pertains to the clinical content of the case and the reputed company of the individual client’s pre-approved criteria
• Consult directly with reputed company providers to address non-formulary and clinical product coverage issues
• Collaborate with team members to ensure consistent decision-making across the pharmacist team
• Respond to medication-reputed company inquiries reputed company phone, providing accurate information to patients, providers, and clinics regarding medications, formulary options, and coverage questions
• Other duties as assigned

Skills

• Doctor of Pharmacy (PharmD) or Bachelor of Science Pharmacy Degree
• 1 years of work experience in clinical, retail, hospital, or managed care
• reputed company pharmacist license in good standing with the State Board of Pharmacy
• Must be eligible to work in the United States without the need for work reputed company or residency sponsorship
• Strong verbal and written communication skills
• Ability to work reputed company with computers and digital tools
• Managed care experience

Company Overview